Department of Obstetrics and Gynecology

Instruction in obstetrics and gynecology is provided during all four years of the medical curriculum. As a component of the anatomy course offered during the first year, students are introduced to the topic of the female pelvic cavity by an introductory lecture that brings to life clinical correlations with the understanding of anatomy and embryology. Teaching in the second year is designed to correlate basic science with the physiologic basis of normal pregnancy and parturition, reproductive biology, infertility and reproductive endocrinology, and gynecologic malignancies. All third-year medical students participate in a six-week clinical clerkship in obstetrics and gynecology. This is divided into three two-week components of outpatient OB-GYN, inpatient obstetrics and inpatient gynecology. During the fourth year, students may elect a subinternship in one of the listed clinical subspecialties, a special studies elective, or a research elective.

The main criteria for this rotation is that the student must have prior experience as an undergraduate or postgraduate in a laboratory, not including class work. This rotation is designed for the student who is planning a career in academic medicine as a physician-scientist and who is interested in considering reproductive science as a field. Prior to signing up for this course, the student must contact Dr. England to discuss the schedule and expectations of the rotation.

Faculty Department Head
George M. Macones, MD, MSCE

M45 ObGyn 635B Obstetrics and Gynecology
The obstetric component of this course emphasizes the physiologic basis of normal pregnancy, parturition, and labor and delivery, and adaptations of other organ systems to pregnancy. Pathophysiology of pregnancy and deviations from normal labor will also be introduced. The gynecologic component of the

M45 ObGyn 730 OB-GYN Clerkship
All third-year medical students participate in a six-week clinical clerkship in Obstetrics and Gynecology. This is divided into three two-week components of outpatient OB-GYN, inpatient obstetrics and inpatient gynecology. Comprehensive study of the reproductive health needs of women in both the office setting and the surgical setting is the focus of the curriculum. Students are actively involved in all settings of health care delivery: outpatient faculty clinics within all specialties, resident ambulatory clinics, operating rooms for all obstetric or gynecologic cases, inpatient floors of L&D and Gynecology, and the emergency department/hospital inpatient consults. Faculty, fellows, residents and nurse practitioners provide teaching for this rotation. Student-directed didactics include the faculty and chief resident lecture series, procedural skill station session and faculty-assigned preceptor groups that meet throughout their sixweek rotation. Credit 231 units.

M45 ObGyn 804 OB-GYN Outpatient Care Subinternship
This experience is designed to primarily acquaint the student with the diagnosis and care of outpatients. Students will work one-on-one with attending staff to focus on an overview of the evaluation, diagnosis, and treatment of common obstetric and gynecologic concerns. The subintern will spend the majority of time attending half-day clinics and private offices. Overnight OB call is required (approximately two evening shifts) to acquaint the student with the house staff and hospital and to provide opportunities for them to participate in deliveries. If desired, additional time can be arranged to participate in/observe outpatient surgical procedures. A 30-to 45-minute presentation to attendings and house staff on a selected OB-GYN topic will culminate the rotation.

M45 ObGyn 810 OB-GYN Endocrinology & Infertility Subinternship
The subintern will participate (in the office and hospital) in the study and treatment of women with reproductive endocrine disorders and infertility. The student will attend and present at conferences, attend surgery, observe assisted reproductive technology procedures, have assigned reading, and be an integral part of the reproductive endocrine service. Opportunities for clinical research projects in reproductive endocrinology are also available.

M45 ObGyn 830 Gynecologic Oncology Subinternship
The subintern will take part in the work-up of tumor patients prior to surgery and/or radiotherapy, assist in pelvic operations, help render perioperative care, and review pathology specimens and slides. The student will participate in GYN Tumor Clinic sessions, make hospital rounds with house staff, accompany chief residents on consultations, and attend OB-GYN conferences. Opportunities for clinical or basic research projects in gynecologic malignancy are also available.

M45 ObGyn 833 Special Topics in Reproductive Health
Students will attend a variety of outpatient clinics to interact with patients seeking different reproductive health services. Topics will include family planning and abortion services at the Hope Clinic and BJH; general gynecology services at our faculty practice GYN clinic (WHC) and the OB/GYN resident clinic (COH 3); specialized reproductive health services including STI testing and contraception at the St. Louis STD clinic, the SPOT, and the C3 Clinic; and OB and pregnancy centering clinics at the Center for Outpatient Health and Affinia. There may also be an opportunity to attend an adolescent and pediatric gynecology clinic, a women's cardiology clinic, and an adult transgender care clinic. Clinical experiences will be mainly ambulatory, but there is potential to work with the Family Planning faculty physicians in the operating room at Barnes-Jewish Hospital. The student will prepare a 15-to 20-minute presentation on a reproductive health topic of their choice to present at the end of the rotation.

M45 ObGyn 843 Maternal-Fetal Medicine Outpatient Care Subinternship
Students will see a variety of high-risk obstetrical patients in the outpatient setting at the Center for Outpatient Health. The student will evaluate various types of reproductive-age patients with medical or obstetrical complications, including preconception consultations, prenatal care consultations, and initial prenatal visits. The student will also see return patients to experience the continuity of prenatal care. Students will participate in antenatal testing and learn basic ultrasonography skills. The student will be responsible for one presentation to be given to the OB teams at the end of the rotation. Students are provided independent study time to put together the presentation, which should be in PowerPoint and on a topic of their choice, inspired by a patient-related clinical condition that peaked their interest during the block. In addition, the student will have the option to take overnight call or call in the Pregnancy Assessment Center in order to gain more hands-on experience with inpatient obstetrics. This is voluntary and not a requisite.

M45 ObGyn 844 Maternal-Fetal Medicine Inpatient (Antepartum) Subinternship
Subinterns will participate in the antepartum and intrapartum management of high-risk hospitalized patients. There is limited interaction with outpatients through the High-Risk Obstetrics Clinics and the Center for Diabetes in Pregnancy. Examples include diabetes, hypertension, renal disease, hematologic abnormalities, preterm labor, and others. Antepartum evaluation and monitoring of the pregnant woman and her fetus are emphasized. Supervision is by the antepartum chief resident and a maternal-fetal medicine faculty member and fellow. An opportunity for intense labor and delivery experience with the Night Team is also encouraged. Students will spend time observing diagnostic obstetric ultrasound examinations. The student will prepare a brief talk on a topic of their interest during the course of the rotation.

M45 ObGyn 856 OB-GYN Ultrasound -Genetics
Working with the attending physicians in the Ultrasound Units at the Center for Advanced Medicine and the Center for Women's Wellness at Missouri Baptist Medical Center, the student will learn the principles and techniques of noninvasive screening for fetal disorders and observe the performance of invasive prenatal diagnostic procedures. The student will also learn the standards and guidelines for the performance of the antepartum obstetrical ultrasound examination and the female pelvic examination. Normal and abnormal fetal and gynecologic anatomy will Department of Obstetrics and Gynecology (03/10/20) be reviewed. Experience will be gained in pedigree analysis and familial risk factor assessment by working with genetic counselors. One day is spent in the Cytogenetics Laboratory observing the preparation of prenatal specimens for karyotype analysis. Opportunities for participation in clinical research are also available.

M45 ObGyn 861 GYN Female Pelvic Medicine & Reconstructive Surgery (Urogynecology) Subinternship
The subintern will take part in the office evaluation of patients with pelvic floor disorders (including pelvic organ prolapse, urinary incontinence, fecal incontinence, and birth injuries), assist in pelvic floor reconstructive surgical procedures, and participate in perioperative care. The subintern will participate in office sessions and surgical cases and will be responsible for rounding with the urogynecology resident on service and for participating in consultations. The subintern will attend FPMRS didactic educational sessions and OB-GYN conferences. The subintern will be required to do a 45-minute presentation on an urogynecologic topic of their choice by the end of the rotation. Opportunities for clinical research projects in urogynecology are also available.

M45 ObGyn 900 Research Elective -Obstetrics and Gynecology
Research opportunities may be available. If interested, please contact the Department of Obstetrics and Gynecology.